左右半结肠癌临床病理特点差异分析

doi:10.3877/cma.j.issn.1674-3946.2019.05.012

目的

探讨左右半结肠癌临床病理特点的差异。

方法

回顾性分析2012年至2017年间收治的左右半结肠癌患者292例资料，以横结肠中段为分界，分为左半结肠癌142例(LCC组)，右半结肠癌150例(RCC组)。采用spss17软件进行统计处理，临床病理特征数据用(±s)表示，独立样本t检验；临床基本特征采用卡方检验，P<0.05为差异有统计学意义。

结果

RCC组中大于65岁的患者比例较高。LCC组患者比RCC组患者更容易接受急诊手术(14.8%比7.3% P＝0.042)。左右半结肠癌患者中在肿瘤T4分期、阳性淋巴结数目、清扫淋巴结总数差异均存在统计学意义(P<0.05)：RCC组中淋巴结转移(阳性淋巴结)的数量明显高于LCC患者(P＝0.034)。淋巴结清扫的总数在RCC组(21.8±8.9)枚也显著多于LCC组(16.4±6.8)枚，(P<0.01)。

结论

左右半结肠癌是两种不同实体疾病，两者临床病理特点具有显著差异，右半结肠癌患者更倾向于区域内淋巴结的转移。

关键词: 结肠肿瘤, 病理学，临床, 对比研究

Objective

To investigate the difference of clinicopathological characteristics between left and right colon cancer.

Method

Retrospective analysis were performed in 292 patients with left or right colon cancer from 2012 to 2017, of whom 142 cases of left colon cancer were divided into LCC group and 150 cases of right colon cancer into RCC group. Statistical analysis was carried out by using spss17 software. The clinicopathological characteristics were expressed as (±s) and were examined by independent t test. The basic clinical features were examined by chi square test. A P value of <0.05 was considered as statistically significant.

Results

The proportion of patients over 65 years old was higher in RCC group. Patients in LCC group was more likely to undergo emergency surgery than patients in RCC group (14.8% vs. 7.3% P=0.042). There were significant differences in T4 staging, number of positive lymph nodes, total number of harvested lymph nodes, and lymph node metastasis rate between the two groups respectively (P<0.05). In RCC group, the number of lymph node metastases (positive lymph nodes) was significantly higher than that in LCC patients (P=0.034). The total number of harvested lymph nodes in RCC group of (21.8±8.9) was also significantly higher than (16.4±6.8) in LCC group (P<0.01).

Conclusions

The left and right colon cancer are different kinds of tumor diseases. The clinicopathological characteristics of them are significantly different. Patients with right colon cancer are more likely to have regional lymph node metastasis.

Key words: Colonic neoplasms, Pathology, clinical, Comparative study

表1 292例左右半结肠癌两组患者的临床基本特征比较[例(%)]

临床特征		RCC(n＝150)	LCC(n＝142)	χ²	P
性别		?	?	?	?
?	男	91(60.7)	84(59.2)	0.069	0.792
?	女	59(39.3)	58(40.8)	0.069	0.792
年龄		?	?	?	?
?	<65岁	62(41.3)	75(52.8)	3.862	0.049
?	≥65岁	88(58.7)	67(47.2)	3.862	0.049
手术方式比		?	?	?	?
?	择期	139(92.7)	121(85.2)	4.155	0.042
?	急诊	11(7.3)	21(14.8)	4.155	0.042

表1 292例左右半结肠癌两组患者的临床基本特征比较[例(%)]

临床特征		RCC(n＝150)	LCC(n＝142)	χ²	P
性别		?	?	?	?
?	男	91(60.7)	84(59.2)	0.069	0.792
?	女	59(39.3)	58(40.8)	0.069	0.792
年龄		?	?	?	?
?	<65岁	62(41.3)	75(52.8)	3.862	0.049
?	≥65岁	88(58.7)	67(47.2)	3.862	0.049
手术方式比		?	?	?	?
?	择期	139(92.7)	121(85.2)	4.155	0.042
?	急诊	11(7.3)	21(14.8)	4.155	0.042

表2 292例左右半结肠癌两组患者的临床病理特征比较[(±s)，例(%)]

病理学特征		RCC(n＝150)	LCC(n＝142)	统计值	P值
肿瘤直径(cm)		?	?	?	?
?	≥5	75(50.0)	79(55.6)	0.929	0.335
?	<5	75(50.0)	63(44.4)	0.929	0.335
阳性淋巴结转移(枚)		5.7±2.6	2.9±1.6	4.499	0.034
平均清扫淋巴结(个)		21.8±8.9	16.4±6.8	6.504	<0.01
淋巴结转移率		0.1±0.2	0.1±0.1	1.046	0.017
pT分期(%)		?	?	?	?
?	T1	7(4.7)	5(3.5)	?	0.043
?	T2	18(12.0)	29(20.4)	?
?	T3	50(33.3)	52(36.6)	?
?	T4	75(50.0)	56(39.5)	?
远处转移		?	?	?	?
?	M0	148(98.7)	137(96.5)	1.492	0.222
?	M1	2(1.3)	5(3.5)	1.492	0.222

表2 292例左右半结肠癌两组患者的临床病理特征比较[(±s)，例(%)]

病理学特征		RCC(n＝150)	LCC(n＝142)	统计值	P值
肿瘤直径(cm)		?	?	?	?
?	≥5	75(50.0)	79(55.6)	0.929	0.335
?	<5	75(50.0)	63(44.4)	0.929	0.335
阳性淋巴结转移(枚)		5.7±2.6	2.9±1.6	4.499	0.034
平均清扫淋巴结(个)		21.8±8.9	16.4±6.8	6.504	<0.01
淋巴结转移率		0.1±0.2	0.1±0.1	1.046	0.017
pT分期(%)		?	?	?	?
?	T1	7(4.7)	5(3.5)	?	0.043
?	T2	18(12.0)	29(20.4)	?
?	T3	50(33.3)	52(36.6)	?
?	T4	75(50.0)	56(39.5)	?
远处转移		?	?	?	?
?	M0	148(98.7)	137(96.5)	1.492	0.222
?	M1	2(1.3)	5(3.5)	1.492	0.222

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Clinical analysis of the clinicopathological characteristics of left and right colon cancer

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Clinical analysis of the clinicopathological characteristics of left and right colon cancer